Stress-induced Drinking in OEF/OIF Veterans: The Role of Combat History and PTSD

描述（由申请人提供）：暴露于与战斗有关的创伤事件的军事人员，特别是那些发展创伤后应激障碍（PTSD）的人，有更高的酗酒问题发生率。然而，很少有人知道创伤，创伤后应激障碍和饮酒之间的关系，在“新兴的成年人”（年龄21-30岁），尽管这个年龄组是在最高的风险，发展随后的饮酒问题。拟定的临床实验室项目将采用三组设计。目标OIF/OEF人群将无创伤暴露[对照组]、无创伤应激障碍的战斗创伤暴露[TE组]和创伤应激障碍的战斗创伤暴露[创伤应激障碍组]。创伤性事件暴露史的类型将限于与战斗有关的创伤性事件，这些事件本质上是人际关系。本项目将使用我们小组采用的成熟的临床实验室应激诱导范例，特里尔社会应激试验（TSST），以研究暴露于战斗创伤的历史对TSST反应性和应激诱导的自愿饮酒的作用。受试者将不符合酒精依赖的诊断标准。每组中的一半将接受TSST，另一半将随机分配至无强制降解条件。使用主观的以及生物指标的压力，第一个具体的目的是检查战斗创伤史的压力反应的影响，使用主观的，神经内分泌，和生理措施的压力。第二个具体目标将使用临床实验室范例中的既定程序来检查战斗创伤史对随后的饮酒行为和对酒精的主观反应的影响。此外，本研究亦将探讨战伤史组与主观应激反应、战伤史组与饮酒的相关性。另外两项探索性分析将评估痛苦耐受性（高和低）人格特质的影响，以及携带5-HTTLPR多态性的“S”或罕见的“LG”等位基因对压力反应和自愿饮酒的影响。应激诱导。这项研究将促进我们对战斗相关创伤事件，压力和饮酒史之间关系的理解。这一系列研究的最终目标是在不健康的饮酒习惯和/或依赖发展之前，在饮酒生涯的早期确定“高危”群体。这些信息有可能为预防和干预酒精研究提供信息。 公共卫生相关性：通过提供一组相对被忽视的受试者（21-30岁之间的OIF/OEF年轻成年人，他们曾经历过与战斗有关的创伤事件）的压力和饮酒相互作用的相关数据，有可能预防酒精依赖的发展，从而降低个人和社会的成本。

DESCRIPTION (provided by applicant): Military personnel exposed to combat-related traumatic events, particularly those who develop posttraumatic stress disorder (PTSD), have a higher incidence of problematic drinking. However, little is known about the relationship between trauma, PTSD, and drinking in "emerging adults" (ages 21-30 years), in spite of this age group being at highest risk of developing subsequent drinking problems. The proposed clinical laboratory project will use a three group design. The target OIF/OEF population will have no trauma exposure [Control group], combat trauma exposure without PTSD [TE group], and combat trauma exposure with PTSD [PTSD group]. The type of traumatic event exposure history included will be limited to combat- related traumatic events that are interpersonal in nature. This project will use a well-established clinical laboratory paradigm of stress induction employed by our group, the Trier Social Stress Test (TSST), to investigate the role of a history of exposure to combat trauma on reactivity to the TSST and on stress- induced voluntary drinking. Subjects will not meet diagnostic criteria for alcohol dependence. Half of each group will receive the TSST and the other half will be randomized to the no stress condition. Using subjective as well as biological indices of stress, the first specific aim examines the effect of combat trauma history on stress reactivity, using subjective, neuroendocrine, and physiological measures of stress. The second specific aim will examine the effect of combat trauma history on subsequent drinking behavior and subjective response to alcohol using established procedures in a clinical laboratory paradigm. Exploratory analyses will also be conducted to examine the correlation between combat trauma history group and subjective response to stress, and combat trauma history group and drinking. Two additional exploratory analyses will evaluate the effect of the personality trait of distress tolerance (high and low), and the effect of carrying the 'S' or the rare 'LG' allele of the 5-HTTLPR polymorphism on the stress response and on voluntary drinking following stress induction. This study will advance our understanding of the relationship between a history of combat-related traumatic events, stress, and drinking. The ultimate goal of this line of research is to identify "at risk" groups early in their drinking careers, before unhealthy drinking practices and/or dependence develop. This information has the potential to inform prevention and intervention alcohol research. PUBLIC HEALTH RELEVANCE: By providing data related to the interaction of stress and drinking from a relatively neglected group of subjects, young OIF/OEF adults between 21-30 who have been exposed to combat-related traumatic events it may be possible to prevent alcohol dependence from developing and, thereby, reduce the magnitude of costs to the individual and to society.